Enhancing Trainee Knowledge and Competence in Addiction Medicine: Outcomes of an Interprofessional Addiction Consult Service Rotation.

Abstract

Many graduating physicians remain inadequately prepared to manage substance use disorders (SUDs) due, in part, to insufficient SUD training during residency, especially in inpatient settings. The aim of the study is to evaluate the impact of a novel addiction medicine consult service (ACS) rotation on residents' knowledge and confidence when serving patients with SUD. The setting is two Oregon teaching hospitals. Twenty-three internal medicine, family medicine, and emergency medicine resident physicians participated. A 2-week rotation on a hospital-based interprofessional ACS was done. Clinical experiences were augmented with self-directed didactics with learning objectives including addiction neurobiology, SUD diagnosis, medications for SUD, and withdrawal management. Twenty-three (74%) participants completed pre- and post-rotation surveys that included 10 multiple-choice knowledge questions and 10 Likert-scale confidence items related to the course's learning objectives. Mean knowledge scores improved from 70.4% pre-rotation to 80.0% post-rotation (p = 0.024, r = -0.332). Self-reported confidence increased in nine of 10 domains (p < 0.001, r -0.505 to -0.603). Participants demonstrated significant improvements in both confidence and objective knowledge. This hospital-based, interprofessional clinical rotation with self-directed didactics may serve as a model for integrating effective addiction medicine training into residency programs and closing gaps in SUD care.